I’ve Been Thinking about melanoma, a two-letter word, the Dominican Republic, and Twitter

April 1, 2009 | In: I've Been Thinking

I’ve been thinking about melanoma, a two-letter word, the Dominican Republic, and Twitter.

Seems like my monthly newsletter comes due every two weeks. I’ve abandoned the fantasy of getting ahead and am settling these days for the illusion that I might be catching up. Speaking of two weeks, the middle two of March were medically eventful.

A mole observed during a routine physical prompted my doctor to immediately remove a hunk of flesh from my forearm. The pathology report came back: malignant melanoma cells to the depth and breadth of the sample. Within days I was in a hospital undergoing scans and going under the knife.

The hope was that the melanoma had not drifted into my lymphatic system and that surgery would remove all the malignant cells.

An interesting thing happened in radiology during lymph-node mapping. The hot spots showing up on the screen from the radioactive dye were initially ambiguous. They couldn’t tell if the spot nearest the forearm was a node or simply a bend in the channel. Concluding it was a node, the attending physician put an “X” on the spot with surgical ink. Fifteen additional minutes convinced him that the spot under the “X” was a bend in the channel after all and that the nearest lymph node was really several inches higher. Unable to wipe off the ink, he decided it might be best to write “NO” over the “X” to erase any ambiguity. However, the technician noted that from where he stood, it looked like “ON.” So, the physician added some letters to read “NOT HERE” before marking the proper site. I like team medicine.

Right before wheeling me to the OR, the surgeon’s assistant commented on all the markings on my arms. They wanted to know about the “other arm!” that I had written on my right arm (which, of course, was the wrong arm). In discussing the etymology of “NOT HERE,” someone suggested that underlining NO would have solved the problem. Another suggested even that might be interpreted as an abbreviation for nodule.

Laurie Morgan’s 1993 Billboard hit “What Part of No Don’t You Understand” was vamping in my head.

Ten days after the operation, the surgeon called to deliver my pathology report. There was no part of the two-letter word that I did not understand. “No melanoma in your lymph nodes,” he said, “and we were able to remove all the cancerous cells from your forearm.”

Tomorrow, I’m heading for the Dominican Republic to attend my son’s wedding. Yes, I’ve packed the sunscreen. I have a lot to be grateful for, including the many friends and loved ones who pulled and prayed for me, most of whom, when they heard my good report said, “Thank God!”

I agree and have followed their advice.

Oh, yeah, I also said I’ve been thinking about Twitter! Well, actually, I quit thinking about it and have joined the other zillion birds on the wire. Anyone interested in catching my Tweets may click here.

What do you think?

Mark Neuenschwander a.k.a. Noosh
mark@hospitalrx.com

PS: By the way, I wasted no time in sending my story to Neil Davis for adding to his 25-year collection entitled MEDICAL ABBREVIATIONS: 30,000 Conveniences at the Expense of Communication and Safety. I’ll be looking for NO in the next edition.

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